Rehabilitation in Pandemics is an integral component of a comprehensive management

Stroke in COVID-19 Patients under 50

Five cases of large-vessel stroke in patients younger than 50 years were reported from New York in the New England Journal of Medicine. All five patients tested positive for Covid-19. Two of the patients delayed calling an ambulance because they were concerned about going to a hospital during the pandemic.²

Awareness seems advisable that social distancing, isolation, and reluctance to present to the hospital may contribute to poor outcomes after stroke.

Post Intensive Care Syndrome (PICS)

There are grounds for concern that a significant number of people will emerge from intensive care with Post Intensive Care Syndrome (PICS) and that being on a ventilator battling through COVID-19 in intensive care for more than a week may result in disability.³

During a stay in the intensive care unit (ICU) the most common form of physical impairment acquired is neuromuscular weakness, with more than 25% of individuals having poor mobility, recurrent falls, or paresis.⁴

A study in survivors of severe critical illness shows that early physical and occupational therapy during critical illness are the best evidence-based target interventions for reducing the long-term physical complications.⁴

Recent experience from Italy already reveals that especially patients with serious COVID-19 illness need a tailored neuromotor and respiratory rehabilitation program.⁵

OMEGO® Plus may help with rehab during COVID-19 by sup-porting early rehabilitation & a comprehensive therapy pro-gram within one device.

• Reduce number of times a patient moves between diffe-rent devices.
• OMEGO® Plus addresses endurance, strength and coordi-nation all in one device.
• Disinfection once per session and not after every device.
• Software guided goal-oriented therapy sequences can reduce the number of physical interactions between pa-tients and therapists.
• Multiple OMEGO®’s can be safely spaced apart and allow the treatment of several patients at once by a single therapist. This facilitates continuous indirect supervision of all patients with minimal direct contact.

References

1 Kansagra AP, Goyal MS, Hamilton S, Albers GW. Collateral Effect of Covid-19 on Stroke Evaluation in the United States. N Engl J Med. 2020 May 8.
2 Oxley TJ, Mocco J, Majidi S, et al. COVID-19 Cases. Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young. N Eng J Med. 2020 May 13.
3 https://www.rehabpub.com/conditions/fear-of-post-intensive-care-syndrome/? campaign_type=newsletter
4 Fan E, Dowdy DW, Colantouni E, et al. Physical Complications in Acute Lung Injury Survivors: A 2-Year Longitudinal Prospective Study. Crit Care Med. 2014;42(4):849–859.
5 Brugliera L, Spina A, Paola Castellazzi P, et al. Department of Rehabilitation and Functional Recovery, I.R.C.C.S. San Raffaele Scientific Institute, Vita-Salute University, Milan. Rehabilitation of COVID-19 patients. J Rehabil Med 2020; 52:4.
6 Khan F, Amatya B. Medical Rehabilitation in Pandemics: Towards a new perspective. J Rehabil Med. 2020 Apr 9.
7 Pan American Health Organization (PAHO). Rehabilitation considerations during the COVID-19 outbreak. 2020.
8 Aprile I, Germanotta M, Cruciani A, Loreti S, Pecchioli C, Cecchi F, Montesano A, Galeri S, Diverio M, Falsini C, Speranza G, Langone E, Papadopoulou D, Padua L, Carozza M. Upper Limb Robotic Rehabilitation after Stroke: A Multicenter, Randomized Clinical Trial. J Neurol Phys Ther. 2020 Jan; 44(1): 3-14.
9 Calabrò RS, Accorinti M, Porcari B, Carioti L, Ciatto L, Billeri L, Andronaco VA, Galletti F, Filoni S, Naro A. Does hand robotic rehabilitation improve motor function by rebalancing interhemispheric connectivity after chronic stroke? Encouraging data from a randomised-clinical-trial. Clin Neurophysiol. 2019 May; 130(5):767-780.

^{Download as pdf}